Provider Demographics
NPI:1891154183
Name:KEIKO YONEYAMA-SIMS
Entity Type:Organization
Organization Name:KEIKO YONEYAMA-SIMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KEIKO
Authorized Official - Middle Name:
Authorized Official - Last Name:YONEYAMA-SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LMFT
Authorized Official - Phone:720-739-0668
Mailing Address - Street 1:PO BOX 9163
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-0163
Mailing Address - Country:US
Mailing Address - Phone:720-739-0668
Mailing Address - Fax:
Practice Address - Street 1:1805 S BELLAIRE ST STE 465-3
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4305
Practice Address - Country:US
Practice Address - Phone:720-739-0668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-16
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1179106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO77135083Medicaid